Liver cancer on the rise

I've been thinking about the "scare straight" approach, and why it doesn't jive with me (or with science, more on that later).

I’m not into scare tactics, never have been.

I remember in high school how angry I felt when the police officers came to give an anti-drug presentation.

They spread out a body bag on the floor and then had a volunteer (a student!) from the audience come up in front of everybody. They basically said that if you smoked marijuana, you would end addicted to heroin and on the street (and don’t worry, they had a slideshow depicting the most addiction-ravaged people they could find, sitting on the streets with needles stuck in their arms) and would probably end up dead.

Then they asked the volunteer to climb into the body bag and they asked us to imagine how his friends and family would feel.

I was enraged, and marched into my guidance counsellors office, shaking with anger and tears streaming down my face. Even at that age, I knew that a presentation like this could traumatize some kids while having very little effect on the actual outcomes they were striving for, ie stopping kids from using drugs.

And of course, these one-off “scared straight” type programs have since been proven ineffective in actually reducing teen drug use and have actually shown to backfiredcomplete when it comes to milder drugs like weed and cigarettes.

I was sitting at the office yesterday when I friend sent me this article about the increasing number of deaths related to liver disease (and alcohol).

As I read through it, I immediately thought two things.

First, that I wanted to share it with you… because it’s important and yes, dare I say, “sobering” information about what constitutes binge drinking and the effect it has on your liver.

Immediately following that thought was, “I can see how the “scared-straight” peeps could take this and run with it…”

Sure enough, while I was scrolling through social media before bed last night (not part of my regular bedtime routine - I was actually doing it intentionally), I saw leaders in the "sober" communities sharing this article as evidence as to why alcohol is evil and should be abstained from completely.

And then in the comments under their posts, I saw responses like:

“See, this is why we should NEVER DRINK.”

“OMG, and yet the article still talks about moderation, AS IF IT’S EVER A GOOD IDEA TO DRINK.”

“This article writes about how alcohol is poisoning your liver and then tells us it’s okay to drink, WTF, it’s NOT.”

And also people who were reading these comments and were genuinely really concerned and fearful about the damage they may have caused their livers, and I could see them spiralling down a rabbit hole of worry and regret.

Yes, this surge of liver cancer and the studies showing how alcohol can affect us IS scary, but remember, knowledge is power. 

If you’re worried about something, go get your liver functioning checked, and make the necessary changes!  Unless you have advanced cirrhosis, most liver damage IS reversible.

(fun fact, when I was 20 years old I was hired as the coordinator for YouthCO AIDS Society’s provincial Hepatitis C program… so I actually know A LOT about the liver!! Questions - ask me!!)

If you are worried about the potential of liver damage and how your drinking might have contributed, use this information as the motivation to make some changes, whether or not you are ready, or even want to, stop drinking completely.

If you read this article and realize that sometimes you drink to the extent that would be considered ‘binge drinking’  (4 or more drinks in one sitting) then consider reducing the amount that you drink in a sitting by at least one drink. For example, if you’re used to drinking 5 drinks in a night out, the next time you go out, try for 4, or 3.

If you read this article and are worried that your daily drinking might be taking its toll on your liver, try reducing the amount you drink daily by half a glass, then a glass, or taking a day off to start, then two.

To help you get started, I’m sharing the worksheets that were previously reserved for my private clients. In these worksheets, you can create your vision of what you’d like your relationship to alcohol to look like, understand what needs were being met by alcohol, and how to create an “alcohol agreement” with yourself to stick to your new intentions.

Once you’ve completed the first worksheets, you may realize you want to go deeper into the journey of “redefining sobriety” aka your relationship to alcohol. I designed the Redefining Sobriety Self-Study program specifically with this in mind. In this 8-week program, you will be guided through pre-recorded videos and worksheets to create strategies that work for you and create lasting change. You can click here to read more about the self-study program and get started today.

If you’d like SUPPORT around how to do this, please reach out. I always love connection calls and have opened up some extra time in my calendar next week.

This is EXACTLY what I do - provide non-judgemental support and tailor strategies to meet your unique experiences and desires for yourself and your relationship to alcohol.

Again, knowledge is power.

Remember that your body is beautiful and strong and resilient and WANTS optimal health.

The last thing I want is for you to spiral into a pit of shame and feel paralyzed by regret. We’ve all done things that were harmful to our bodies but there is nothing you can do to change the past other than forgive yourself for the choices you made then, and start to choose differently now.

That's what I'm here to support you with.

Cheers to healthier livers, and lives!! 

Neurobiology Of Change

The first few paragraphs of this blog were adapted from an article on Psychology Today about why we resist change… and how specifically this relates to our habitual relationship with alcohol.

The steps to making meaningful life changes are implicated by areas of the brain that control our habits and conscious decision-making abilities. Our basal ganglia in the ancestral or primitive brain are responsible for “wiring” habits. This cluster of nerve cell bodies is involved in functions such as automatic or routine behaviors (e.g., habits) that we are familiar with or that make us feel good. Such behaviors might include nail biting, smoking cigarettes, drinking alcohol habitually or following the same routine every day without making changes to it.

Social and Personality Researcher Dr Erin Baker describes this process further:  In addition to the basal ganglia, each time a behavior feels good, there is a bit of a dopamine rush. That dopamine rush motivates future behaviors, and as the behavior is repeated, basically dopamine facilitates neurons "connecting" that reinforce the habit. Basically the whole mantra of " neurons that fire together, wire together".

Habits like exercise form when we perform a certain behavior in a specific environment or context. When we do something like put a seatbelt on (an action) when we get into a car (a contextual cue), we develop automaticity, or an automatic behavior in response to the contextual cue. In the “Psychology of Habit,” Wendy Wood and Dennis Rünger from the department of psychology at UCLA wrote that while some of this automatic cuing may be unintentional, deliberately cuing ourselves could help us to engage in particular habits.

Just as coming home after a stressful day at work might have become a “cue” for habitual response such as pouring a glass of wine, we can create new habitual responses. It will take a bit more work initially, because we are activating a different part of the brain and have to engage in conscious action planning for awhile, until this new response or activity becomes a new habit.

Any type of change like incorporating a physical activity into our routine after a period of being sedentary can go against the neural pathways that have become automatic to us. That is why we tend to fall back on our default or automatic behaviors when we try to implement changes like a new diet or physical activity after a period of inactivity.

Although we can consciously control the decision to work out, this is the responsibility of a separate region of the brain known as the neocortex, which controls conscious decision-making in the brain. Our conscious actions require much more effort. If we want to overcome a lack of motivation and other obstacles that are getting in the way of our success, frequent exercise and conscious action planning are involved in making an exercise habit stick, according to Lena Fleig and colleagues(2013).

This is where accountability becomes critical for your behaviour change relate to alcohol. As I frequently say to my clients, “if nothing changes, nothing changes…” You CAN change your relationship to alcohol the same way you change another habitual pattern (as long as there is no physical dependence).

Creating a reward system can also help motivate change in the beginning. Rewards will trigger dopamine, which feels good. Eventually, following through on the new behaviour starts to feel so good that the reward is no longer as necessary. Charles Duhigg describes this in his book, "The Power of Habit." The cue - behavior - reward system, and so it's equally important to reward yourself for creating a new behavior as it is to have a cue. Interestingly, at some point the brain wires so that the behavior itself actually becomes rewarding and the reward is no longer needed.

In her interview for the Redefining Sobriety Summit, Dr Delafield Heinrici, a Board Certified Addictions Physician, talks about the importance of creating change in other aspects of your life (which can help with the neuro-”cueing”) and having other supports in place to help with accountability and motivation for change.

Remember, change is hard… we are literally hard-wired to resist it.

This is why accountability systems are so important, whether they be “cues” like programming reminders in your phone or scheduling alternative activities during times you are more likely to habitually crave a drink, or reaching out to a friend at the same time each day (before you start to crave a drink or fall back into an unconscious habitual response). This is also why having unfailing and non-judgemental support, with a combination of evidence-based strategies (based on information like you’ve just read) and practical, lived experience - is essential. I offer all of this and more in my consultations, and the first one is always free. I look forward to connecting!